Chapter 13: Life Cycle Nutrition: Mother and Infant

The embryo and fetus require

good nutrition

Embryo

•The stage of human gestation from the third to the eighth week after conception

Fetus:

The stage of human gestation from eight weeks after conception until the birth of an infant

A woman who begins her pregnancy underweight and who fails to gain sufficiently during pregnancy is very likely to

bear a baby with a dangerously low birthweight

Low birthweight can potentially impact

impact the infant’s future health

A high-birthweight infant can necessitate

cesarean section ( C-section)

Maternal obesity increases a child’s risk for

•obesity, heart disease, and type 2 diabetes

Low birth-weight

weighs less than 5.5 pounds at birth

Effects of low birthweight

poor nutritional health, low adult IQ, brain impairment and short stature

High birth-weight weigh

more than 9 pounds

Effects of High-birth weight

increase likelihood of heart defects; obesity, heart disease, type 2 diabetes, and asthma

The Placenta is a

supplies depot and waste-removal system for the fetus.

In the placenta, blood containing waste and blood containing nutrients never

mix

The umbilical cord is used as a

conduit

The placenta is composed of

spongy tissue in which fetal blood and maternal blood flow side by side each in it own vessels.

In the placenta, the maternal blood transfers _ to the fetus’ blood and picks up ( )

1. oxygen/nutrients

2. fetal wastes to be excreted by the mother

The placenta performs the __ functions that the fetus will do after the birth

nutritives, respiratory, and excretory

The umbilical cord delivers ( ) and takes out ( )

nutrients/O2 to the fetus and takes out waste

amniotic sac

surrounds fetus and serves as a cushionly fluid

Stages of Embryonic and Fetal Development

1) A newly fertilized ovum, called a zygote, is about the size of the period at the end of this sentence. Less than 1 week after fertilization, the zygote has rapidly divided many times and has become ready for implantation

2) After implantation, the placenta develops and begins to provide nourishment to the developing embryo. An embryo 5 weeks after fertilization is about 1⁄2 inch long

3) A fetus develops after 11 weeks of development and is just over an inch long. Notice the umbilical cord and blood vessels connecting the fetus with the placenta

4) A newborn infant after 9 months of development measures close to 20 inches in length. The average birthweight is about 71⁄2 pounds. From 8 weeks to term, the infant has grown 20-fold in length and 50-fold in weight.

zygote —> embryo —> fetus —> infant

A zygote begins as a

a newly fertilized ovum; a single cell that rapidly divides after fertilization;

ovum

egg

a fetus has a

has a complete central nervous system, a beating heart, digestive system, fingers and toes and facial feature

•Implantation

•Occurs within two weeks of fertilization

The fetus develops significantly by the

eighth week of conception

Fetal period

Months 2 to 9 of pregnancy

Gestation duration

•40 weeks

•Split into trimesters

Gestation contains

•Contains critical periods

•Periods of time specific to the development of specific organs

•High-risk pregnancy

•Risk factors that increase the chances of premature delivery, difficult birth, retarded growth, birth defects, and early infant death

•Prenatal medical care required

If development of organ is limited

recover is impossible and usually occurs because of malnutrition

High risk pregnancy factors

•Prepregnancy B M I either less than 18.5 or less than/equal to 25

•Insufficient or excessive pregnancy weight gain

•Nutrient deficiencies or toxicities; eating disorders

•Poverty, lack of family support, low level of education, limited food availability

•Smoking, alcohol, or other drug use

•Age, especially 15 years or younger or 35 years or older

•Twins or triplets

•Many previous pregnancies (3 or more in mothers younger than age 20; 4 or more in mothers age 20 or older)

•Short or long intervals between pregnancies (less than 18 months or more than 59 months)

•Previous history of problems such as low- or high-birthweight infants

•Pregnancy-related hypertension or gestational diabetes

•Diabetes; heart, respiratory, or kidney disease; genetic disorders; special diets and medications

•Energy

Needs vary with

the progression of pregnancy

____ are used by the fetal brain as fuel

carbohydrates

Is Consumption of supplements discouraged?

Yes

T/F: In the first trimester, women don’t need to increase energy intake

True

T/F: Energy needs increase w/ the progression in pregnancy

T

There a __ calorie energy need increase in the second trimester

340

There is a __ calories energy need increase for the 3rd trimester

450

•Folate helps prevent

•neural tube defects (N T Ds)

The neural tube, comprises the embryonic tissue that later forms the

later forms the spinal cord

Common types of N T Ds are

anencephaly and spina bifida

Risk Factors for Neural Tube Defects

⁃Personal or family history of a pregnancy affected by a neural tube defect

⁃Maternal diabetes

⁃Maternal use of certain antiseizure medications

⁃Mutations in folate-related enzymes

⁃Maternal obesity

•Vitamin B₁₂

•Assists folate in the manufacture of new cells

•Found in meat, eggs, milk, and milk products

anencephaly

upper end of neural tube fails to close: results in death

Spina Bifida

incomplete closure of spinal in bony incasement

•Choline is used for

•Structural integrity of cell membranes

•Synthesis of an important neurotransmitter

•Metabolism of lipids

Vitamin D and calcium is used for

•Necessary for fetal bone growth and tooth development

•Calcium absorption doubles during pregnancy

Vitamin D plays a vital role in calcium absorption

•Iron is used for

•Helps increase blood volume

•Fetal absorption increases in second and third trimesters

All women are advised to consume

•Foods containing heme iron

•Additional sources of iron

•Foods that enhance iron absorption

Use for •Zinc

•Vital for protein synthesis and cell development

•Abundant in protein-rich foods

•Benefits of proper weight gain

•Low risk of surgical birth

•Increased chances of delivering a healthy birthweight infant

T/F: •Weight loss during pregnancy is not recommended

•Sudden and significant weight gain is dangerous

T

Recommended Weight Gains Based on Prepregnancy Weight

•Benefits of physical activity

•Improves fitness

•Facilitates labor

•Helps prevent or manage gestational diabetes

•Reduces psychological stress

•Choose low-impact activities

•Seek medical advice

Guidelines for physical activity during pregnancy

•Cravings

•Do not reflect physiological needs

•Caused by hormone-induced changes in taste and sensitivities to smells

•Aversions are caused by normal hormonal changes and can result in:

•Morning sickness

•Heartburn or indigestion

•Change in muscle tone

•Crowding of intestinal organs by growing fetus

Cautions for Pregnant Women

•Do not smoke cigarettes

•Can kill an otherwise heathy fetus or newborn

•Reduces blood supply to the fetus

•Increases the risk of:

•Complications during delivery

•Sudden infant death syndrome (S I D S)

•Nonsmoking pregnant women

•Exposure to environmental tobacco smoke increases the risk of low birthweight and S I D S

Complications Associated with Smoking during Pregnancy

Medicinal drugs and herbal supplements taken during pregnancy can cause

birth defects

Drugs of abuse easily cross the placenta and impair

•fetal growth and development

Environmental contaminants such as lead may lead to

low-birthweight infants with delayed mental and psychomotor development

Exposure to mercury

Harm caused to the developing fetal brain and nervous system

Foodborne illnesses can leave a pregnant woman

exhausted and dangerously dehydrated

•Pregnant women are more likely than others to contract

listeriosis: •A serious foodborne illness

•Can cause miscarriage, stillbirth, or severe brain or other infections in fetuses and newborns

•Can be avoided by following safe practices

Vitamin A in excess may cause

malformations of the cranial nervous system in the fetus

•Caffeine in __ amounts is allowed

small amounts: •Two cups of coffee are recommended per day

•Alcohol crosses the placenta freely and is directly toxic because

•Can halt the delivery of oxygen through the umbilical cord

•A few minutes of alcohol exposure during fetal brain growth can exert a major detrimental effect

•Interferes with placental transport of nutrients to the fetus and can cause malnutrition in the mother

•Before fertilization, damage can be caused to the ovum or sperm in the mother- or father-to-be, leading to abnormalities in the child

Conditions that affect the fetus if it ingests alcohol

•Fetal alcohol spectrum disorders (F A S D): A spectrum of physical, behavioral, and cognitive disabilities

•A more severe form is fetal alcohol syndrome (F A S): The cluster of symptoms including brain damage, growth restriction, mental retardation, and facial abnormalities seen in an infant or child

•Alcohol-related neurodevelopmental disorder (A R N D): Behavioral, cognitive, or central nervous system abnormalities

•Alcohol-related birth defects (A R B D): Malformations in the skeletal and organ systems such as the heart, kidneys, eyes, ears

•How much alcohol is too much?

•Abstinence is the only acceptable course of action for pregnant women

Pregnant women with unmanaged type 1 or type 2 diabetes may experience

•Severe hypoglycemia or hyperglycemia

•Preterm labor

•Pregnancy-related hypertension

•Infants of women with diabetes may:

•Be large

•Suffer physical and mental abnormalities

•Suffer other complications such as respiratory distress

Gestational diabetes definition and effects

•Abnormal glucose tolerance appearing during pregnancy

•Diabetes risk later in life

•Increased odds of surgical birth, high infant birthweight, and high risk of illness and mortality

Chronic hypertension

•In pregnant women: hypertension that is present and documented before pregnancy

in women whose prepregnancy blood pressure is unknown: the presence of sustained hypertension before 20 weeks of gestation

Gestational hypertension

•High blood pressure that develops in the second half of pregnancy and usually resolves after childbirth

Hypertension increases the risk of

•preeclampsia

Preeclampsia

usually occurs in the first pregnancy and appears after 20 weeks of gestation

• Involves high blood pressure and protein in the urine

• May lead to eclampisa

A nursing mother produces about

25 ounces of milk a day,

•Energy cost of lactation

•500 calories per day above a woman’s need

•Fluid needs:

Prevent dehydration by ensuring extra fluid intake

Nutritional deprivation of the mother reduces

•the quantity of milk

•Not the quality of milk

•Some substances impair maternal milk production or enter breast milk and interfere with infant development

•Alcohol and illicit drugs

•Alcohol concentration peaks within one hour

•Illicit drug users should not breastfeed

•Tobacco and caffeine

•Production of milk and its fat content are less

•Chemicals in cigarettes are transferred to the infant

•Excess caffeine can make the infant jittery and wakeful

•Medications

•A physician must be consulted as danger levels vary

•Oral contraceptives may suppress milk output

Should the mother breastfeed with an illness?

•Common cold: The mother can continue nursing

•Tuberculosis: The mother can continue nursing once she is treated and is no longer infectious

•H I V: If safe alternatives are available, the mother is advised not to breastfeed

The World Health Organization (W H O) recommends

exclusive breastfeeding for the first six months in the absence of suitable alternatives

An infant’s growth is directly affected by

the infant’s nutrition status

Growth is faster during

•the first year in terms of height and weight:

during this time they have a higher •High basal metabolic rate

During the first year for the baby

•Energy nutrients, vitamins A and D, calcium, and water are of special importance

Breastfeeding reccomendations

•An infant’s consumption of human milk with no supplementation of any type for 6 months and breastfeeding with complementary foods for at least 12 months

Breast milk •excels as a

source of nutrients:

•Contains abundant oligosaccharides, alpha-lactalbumin, and lactoferrin

•Alpha-lactalbumin: The chief protein in human breast milk

Lactoferrin: A factor in breast milk that binds iron and keeps it from supporting the growth of the infant’s intestinal bacteria

•Vitamins and minerals in breast milk

•Vitamin D concentration is low, requiring mothers to take supplements

Colostrum:

•A milklike secretion from the breasts during the first day or so after delivery before milk appears; rich in protective factors

•It protects against common illnesses of infancy

formula feeding is

•Is an acceptable alternative to breastfeeding

Special formulas have been designed to meet the dietary needs of infants based on

•Hydrolyzed protein: Commercial protein ingredient made by way of hydrolysis, a type of chemical reaction that splits molecules, in this case long protein chains, into smaller fragments

Cow’s milk

•Not appropriate for children who are less than a year old

•Those younger than 6 months of age can suffer intestinal bleeding, which can lead to or aggravate iron deficiency

cow’s milk provides

protein and less carbohydrate than the ideal amounts for infants.

Infant foods should provide

variety, balance, and moderation

•Foods to omit:

•Food with salt and sugar

•Baby food “desserts”

•Sugar alcohols

•Salted canned foods

•Honey and corn syrup

•Unpasteurized milk, milk products, or juices

•Raw or undercooked eggs, meat, poultry, or fish

•Raw sprouts

Milk anemia

: Iron-deficiency anemia caused by drinking so much milk that iron-rich foods are displaced from the diet